There are 3 primary out-of-pocket costs you’ll want to consider as you begin comparing Medicare plans:
- Copays—A fixed amount ($20, for example) you pay for a covered healthcare service after you've paid your deductible
- Coinsurance—The percentage of costs of a covered healthcare service you pay (20%, for example) after you've paid your deductible
- Deductibles—The amount you pay for covered healthcare services before your insurance plan starts to pay.
Let’s take a look at deductibles. Medicare plans have deductibles just like individual or employer health insurance plans do. Both Original Medicare and, typically, Medicare Advantage Plans, require you to meet a deductible—an amount you pay for healthcare or for prescriptions—before your healthcare plan begins to pay.
Medicare Part A generally helps cover services you receive in a hospital or long-term care setting. Original Medicare requires that you pay a deductible for each inpatient hospital “benefit period,” which means you may have to pay a deductible more than once in a single year.
A benefit period begins the day you're admitted to a hospital or skilled nursing facility and ends when you haven't spent the night in one of them for 60 consecutive days. If you're admitted to a hospital or skilled nursing facility after one benefit period has ended, then a new one begins, and you’ll have to pay another deductible.
The 2023 Medicare Part A deductible for each benefit period is $1,600.1
Medicare Part B covers most doctor services, including those you receive while hospitalized, as well as outpatient therapy and the rental or purchase of durable medical equipment, which is equipment your doctor prescribes because it is medically necessary, like blood sugar monitor test strips, walkers or wheelchairs. After your deductible is met, it’s typical to pay 20% of the Medicare-approved amount for these services.
The total 2023 Part B deductible is $226 for the year. No benefit periods apply to Part B coverage.1
You can buy private Medicare Supplement insurance to cover Medicare’s out-of-pocket expenses, including the hospital deductible.
However, if you’re enrolled in a Medicare Advantage Plan, you can only purchase a Medicare Supplement plan if your Medicare Advantage plan coverage is ending. Medicare Supplement plans cannot be purchased while you are currently enrolled and planning to remain on a Medicare Advantage plan.
